
<div class="pageContent">
	
	<form method="post" action="demo/pagination/ajaxDone2.html" class="pageForm required-validate" onsubmit="return validateCallback(this, dialogAjaxDone)">
		<div class="pageFormContent" layoutH="58">
			<p>
				<label>渠道名称：</label>
				<input type="text" name="chanTypeNum" size="30" readonly value="全天物流渠道" />
			</p>
			<p>
				<label>渠道别名：</label>
				<input type="text" name="chanTypeName" size="30" class="required" readonly value="给力的渠道" />
			</p>
			<p>
				<label>国家：</label>
				<input type="text" name="country" size="15" class="required" value="冰岛"/>&nbsp;&nbsp;&nbsp;&nbsp;
				<input type="text" name="countryCode" size="3" readonly value="BD" />
			</p>
			<p>
				<label>邮编：</label>
				<input type="text" name="area" size="30" class="required" value="67889161" />
			</p>
			<p>
				<label>省：</label>
				<select name="provinceNum" class="combox">
					<option value="-1" selected>请选择</option>
				</select>
			</p>
			<p>
				<label>市：</label>
				<select name="cityNum" class="combox">
					<option value="-1" selected>请选择</option>
				</select>
			</p>
			<p>
				<label>区：</label>
				<select name="areaNum" class="combox">
					<option value="-1" selected>请选择</option>
				</select>
			</p>
			<p>
				<label>费用公式：</label>
				<input type="text" name="cost" class="required" size="30" value="300" />
			</p>
		</div>
		<div class="formBar">
			<ul>
				<li><div class="buttonActive"><div class="buttonContent"><button type="submit">提交</button></div></div></li>
				<li><div class="button"><div class="buttonContent"><button type="button" class="close">取消</button></div></div></li>
			</ul>
		</div>
	</form>
	
</div>

